A wound which the edges are well approximated or sutured or stapled together.

What are pressure ulcers?

localized areas of tissue necrosis that develope when soft tissue is compressed between a bony prominence and an external surface for a prolonged period of time.

What are some other names for pressure ulcers?

decubitus ulcer, bedsore, or dermal ulcer

What are some factors that can affect wound healing?

The extent of the damage or injury, the general health of pt (immune deficiencies, chronic illnesses, etc.), age, nutritional status, effectiveness of the circulatory sys, and medications

What are three possibile methods to wound closure?

Primary intention, Secondary intention, or tertiary intention

What is primary intention of wound closure?

This method occurs when the wound edges are well approximated and sutures or staples are used to maintain and intact the wound.

What is secondary intention of wound closure?

This is used when extensive tissue loss occurs and the wound is open with dressings covering the wound and it heals from the base of the wound.

What is tertiary intention of wound closure?

When a wound is left open because of potential for bacterial contamination. They wounds are kept moist with dressings and closed when risk of infection is minimal.

What are the phases of wound healing?

1. inflammatory phase 2. proliferation phase 3. maturation phase

The activities of the inflammatory phase include __________ and __________.

hemostasis, phagocytosis

What is the first step of the inflammatory phase?

Vasoconstriction occurs and coagulation begins as the body attempts to stop the bleeding.

True or False? During the inflammatory phase growth factors are released by platelets which attract inflammatory cells to the area.

True

During the inflammatory phase migration of _________ cells, __________, and __________ cells is initiated.

epithelial, fibroblasts, vascular

During the inflammatory phase why does edema occur around the wound?

Edema occurs becuase of vasodilation around the area of injury. This fluid contains proteins, enzymes, antibodies and growth factors necessary for healing.

What do macrophages do during wound healing?

They digest microorganisms and other debris, release chemicals that cause vasodilation, and stimulate the activity of the fibroblasts.

What do fibroblasts do during wound healing?

They initiate the production of collagen

What happens during the proliferation phase?

fibroblastic and collagen activity increases, new blood vessels and granulation tissue begins to form, epithelial cells migrate across the wound from its edges, collagen increases and the scar begins to change, and sensory nerves begin to develope (in minor wounds)

What is contraction?

Contraction is when the wound edges move toward the center and the size of the wound bed decreases.

What happens during the maturation phase?

Collagen is rearranged and is termed remodeling. The cells become less vascular and the strength of the tissue increases.

The scar that is formed over a wound is not as strong as the original tissue, why is this?

The reason for this is the scar consists of collagen rather than the original tissue, elastin.

What does the acronym "TIME" mean when considering barriers to healing?

T=tissue
I=infection
M=moisture
E=edges

True or False? Nonviable tissue, such as necrotic tissue, can interfere with the movement of cells needed to build granulation tissue and therefore removal of this tissue is important.

True

What is debridement and what are some different methods to doing it?

It is the removal of necrotic tissue. Surgical debridement is removal using instruments, Mechanical debridement uses force to remove, autolytic debridement is removal using mositure and body's own enzymes, Enzymatic debridement uses topical enzymatic drugs to remove and biological debridement which uses maggots for removal.

True or False? Low amounts of bacteria may actually help healing through the release of proteases or stimulate the release of proteases from neutrophils.

True

wounds with low levels of bacteria that are not replicating or are replicating (colonizing) is considered normal. What is NOT considered normal?

Critical colonization of bacteria that delays wound healing is not normal.

What are some signs and symptoms of critical colonization and impending infection in a wound?